Surgical microscope system

ABSTRACT

A surgical microscope system having a head unit microscope assembly and a foot control assembly in operative communication with the head unit microscope assembly. The head unit microscope assembly being configured to selectively couple to a floor stand assembly such that the that the head unit microscope assembly can be positioned in a desired operative location by the user. The head unit microscope assembly including one or more of: a mounting adaptor, an XY directional stage, a tilt drive, a focus drive; a microscope subassembly, and/or an illumination system.

CROSS REFERENCE

The present Patent Application claims benefit of U.S. Provisional PatentApplication No. 63/278,691 filed Nov. 12, 2021, and claims benefit ofU.S. Provisional Patent Application No. 63/347,131, filed May 31, 2022.

INCORPORATION BY REFERENCE

U.S. Provisional Patent Application No. 63/278,691, filed Nov. 12, 2021,and U.S. Provisional Patent Application No. 63/347,131, filed May 31,2022, are specifically incorporated by reference herein as if set forthin their entireties.

TECHNICAL FIELD

The present disclosure relates generally to systems, apparatus andmethods in the field of surgical microscopes, more particularly, tovarious aspects involving systems, apparatus and methods for improvedmicroscope assisted surgical outcomes using a microscope system thatutilizes single spot, diverging, coaxial illumination.

BACKGROUND

As one will appreciate, any microsurgical procedure requires precisioncutting and/or removal of various body tissues. For example, inophthalmic microsurgical procedures, inner limiting membrane (ILM)removal and epi-retinal membrane (ERM) removal are exemplary surgicaltreatments for different macular surface diseases. However, the surgicaltechniques for ILM and ERM removal require skill and patience. In theophthalmic context and in other microscopic surgical contexts, preciseand carefully constructed surgical instruments are used for each aspectof the surgical technique to ensure a successful outcome for thepatient.

To aid the operator with various microsurgical procedures, operators mayuse an imaging system that presents a microscope subject view of thetissue to be treated, such as a view of the tissue of the patient's eye.In an exemplary ophthalmic surgery context, the user of such an imagingsystem may be provided with a close-up view of the surgical instruments,such as forceps or other tools, as well as the region of the eye that isof interest. In some cases, the operator may also be provided withadditional information that may be useful to the operator in an overlaiddisplay, visible through the eyepieces of the microscope.

In ophthalmic devices and ophthalmic microsurgical procedures,reflections of light sources can be seen in the image of the eye. As aresult, important information about the condition or existing changes inthe eye can be outshined, covered and/or changed. Alternatively, thelight sources used with surgical microscopes to illuminate the surgicalfield in the patient's eye are conventionally focused and resultantlyreach light intensities that are painful to the patient and thatpersists throughout the surgical procedure.

Accordingly, there is a need for continued improvement in the use andoperability of microsurgical systems for microscope-assisted procedures.There is a particular need for improvement in the use and operability ofmicrosurgical systems various ophthalmic procedures where it isdesirable to enhance the clarity of the microscopic view of the targetedtissues and to minimize patient surgical procedure pain, which arecaused by the light source of the surgical microscope system.

SUMMARY

To improve the state of the art, disclosed herein is a surgicalmicroscope system, and methods of use thereof, utilizing novel featuresand functionalities. The surgical microscope system can include at leastone of: a head unit microscope assembly; a foot control assembly inoperative communication with the head unit microscope assembly; a floorstand configured to support the head unit microscope assembly in adesired operative position; a remote viewing assembly in operativecommunication with the head unit microscope assembly; and a head restassembly that allows a surgeon to rest their head into a custom fitsupport device in order to alleviate strain on the surgeon's neck andupper back muscles by allowing the surgeon to rest the weight of his/herhead against the face piece during surgery.

In one aspect, the head unit microscope assembly can have a mountingadaptor that is configured to operatively couple to any existingsurgical microscope floor stand, regardless of brand, which allows forupgrade of a surgical microscope's optical portion to provide functionsand benefits that are not currently available in dated prior existingsurgical microscopes. In a further aspect, the head unit microscopeassembly is configured to house the head unit movement subassembly andthe control system for the surgical microscope system. Thus, in oneaspect, it is contemplated that the presented head unit microscopeassembly can be configured to be self-contained, i.e., all of themechanical; electronic controls, computer systems, programing, etc.necessary for operation of the head unit microscope assembly is formedas a portion of the head unit microscope assembly. Optionally, if thefloor stand that the head unit microscope assembly is retrofittedthereto contains operational electronics, the head unit microscopeassembly can be configured to selectively communicate with the floorstand electronics.

The foot control assembly can operate as the primary control interfacefor the head unit microscope assembly. In one aspect, the foot controlassembly can comprise a wireless, battery operated device that isconfigured to reduce cord clutter in an operating room and can furtherhave control switches that are positioned in a conventional surgicalcontrol layout. In this aspect, it is contemplated that the controlswitches for the foot control assembly can comprise at least one of useshall effect (magnetic) and/or optical switches for increased surgicalreliability.

The floor stand assembly can be optionally used if the user does nothave a current upgradable floor stand or wants added features that areprovided by the floor stand assembly. The floor stand assembly isconfigured to be light weight, when compared to existing surgicaloperating microscopes, which allows for easier movement of the floorstand and the coupled head unit microscope assembly by the user. Tostabilize the floor stand assembly, the floor stand is configured toaccept the mounting of conventional weight plates, which allows theselective addition of the required ballast to insure the desiredpositional stability of the surgical microscope system.

The remote viewing assembly is in operative communication with the headunit microscope assembly and can comprise an opposed pair of highresolution cameras that are configured to produce a left and right viewof the image in the microscope, which are subsequently combined anddisplayed on a remote 3D monitor. A user can use passive 3D glasses toperceive the displayed 3D image. Alternatively, the remote viewingassembly is configured to allow for the user to use the conventionalbinocular view of the microscope to view the image concurrently with theview of the image being presented on the remote 3D monitor.

The headrest assembly is attachable to the head unit microscope assemblyand is configured to support the head, neck and back of a user who leansagainst it, and the invention provides a selectable position againstwhich the user may lean in order to prevent neck and back strain.

Still other aspects, embodiments, and advantages of these exemplaryaspects and embodiments, are discussed in detail below. Moreover, it isto be understood that both the foregoing information and the followingdetailed description are merely illustrative examples of various aspectsand embodiments, and are intended to provide an overview or frameworkfor understanding the nature and character of the claimed aspects andembodiments. Accordingly, these and other objects, along with advantagesand features of the present invention herein disclosed, will becomeapparent through reference to the following description and theaccompanying drawings. Furthermore, it is to be understood that thefeatures of the various embodiments described herein are not mutuallyexclusive and can exist in various combinations and permutations.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are included to provide a furtherunderstanding of the embodiments of the present disclosure, areincorporated in and constitute a part of this specification, illustrateembodiments of the present disclosure, and together with the detaileddescription, serve to explain the principles of the embodimentsdiscussed herein. No attempt is made to show structural details of thisdisclosure in more detail than can be necessary for a fundamentalunderstanding of the exemplary embodiments discussed herein and thevarious ways in which they can be practiced. According to commonpractice, the various features of the drawings discussed below are notnecessarily drawn to scale. Dimensions of various features and elementsin the drawings can be expanded or reduced to more clearly illustratethe embodiments of the disclosure.

FIG. 1 schematically illustrates an example of a surgical microscopesystem showing a head unit assembly configured to connect to a floorstand that can be used in the exemplary surgical microscope system.

FIG. 2 schematically illustrates the surgical microscope system of FIG.1 .

FIG. 3 schematically illustrates an example of a head unit assembly forthe surgical microscope system, showing a mounting adaptor, an XYdirectional stage, a tilt drive, a focus drive; a microscopesubassembly, and an illumination system.

FIG. 4 schematically illustrates an example of an XY directional stagethat is configured to for controlling the movement of the head unitassembly with respect to the floor stand along an X-Y plane, right-leftand forward-back.

FIG. 5 schematically illustrates a partially transparent example of anXY directional stage that is configured to for controlling the movementof the microscope subassembly with respect to the mounting adaptor alongan X-Y plane, right-left and forward-back.

FIG. 6 schematically illustrates an example of a tilt drive that isconfigured for controlling the angular movement of the microscopesubassembly with respect to the longitudinal axis of the mountingadaptor.

FIG. 7 schematically illustrates a partially transparent example of thetilt drive of FIG. 6 .

FIG. 8 schematically illustrates an enlarged view of the tilt drive ofFIG. 5 , showing a first and second gear.

FIG. 9 schematically illustrates an example of a focus drive that isconfigured to for controlling the movement of the microscope subassemblyalong a Z-axis relative to the selective operative axis of the tiltdrive.

FIG. 10 schematically illustrates an example of a microscope subassemblythat is configured to mount to the focus drive of FIG. 9 .

FIG. 11 schematically illustrates an example of a microscope subassemblythat is configured to use three light sources for illumination—twooblique and one central or coaxial, which light sources can beindependently controlled to allow the user to fine tune the ratio oflight directed to the target tissue.

FIG. 12 schematically shows a prior art illumination system that usestwo beams of coaxial illumination and one beam of oblique illumination.

FIG. 13 schematically shows a prior art illumination system in whichlight energy passes through the objective lens that resultantly providessome general “focused light” or convergence.

FIG. 14 schematically shows a prior art illumination system in whichcollimated light, one for each optical pathway—the left and the righteye, is used that does not pass through the objective lens and does nottend to converge.

FIGS. 15A and 15B schematically show the application of a single centralbeam of divergent light to fill the targeted tissue area with light.

FIG. 16 schematically shows the application of a single central beam ofdivergent light, which does not pass through the objective lens of themicroscope, to fill the targeted tissue area with light.

FIG. 17 schematically shows a control system for the operation of thesurgical microscope system.

FIG. 18 schematically shows a control system for the operation of aremote viewing assembly that can be used in the exemplary surgicalmicroscope system.

FIG. 19 schematically illustrates an example of a remote viewingassembly that can be used in the exemplary surgical microscope system.

FIG. 20 illustrates a schematic function diagram, in an embodiment, ofthe remote viewing assembly of FIG. 19 .

FIG. 21 schematically illustrates an example of a Z axis assembly of theremote viewing assembly that can be used in the exemplary surgicalmicroscope system.

FIG. 22 schematically illustrates an example of a XY axis assembly ofthe remote viewing assembly that can be used in the exemplary surgicalmicroscope system.

FIG. 23 schematically illustrates an example of a rotation assembly ofthe remote viewing assembly that can be used in the exemplary surgicalmicroscope system.

FIG. 24 illustrates a process flow, in an embodiment, of home screenoperation for the surgical microscope system.

FIG. 25 illustrates a process flow, in an embodiment, of home screencontrols for the surgical microscope system.

FIG. 26 illustrates a process flow, in an embodiment, of home screencontrols for the surgical microscope system.

FIG. 27 illustrates a process flow, in an embodiment, of home screencontrols for the surgical microscope system, showing “speed” selectionsto allow a user to select stored system settings.

FIG. 28 illustrates a process flow, in an embodiment, of override homescreen controls for the surgical microscope system.

FIG. 29 illustrates a process flow, in an embodiment, of user setup homescreen controls for the surgical microscope system.

FIG. 30 schematically illustrates an example of a foot control assembly.

FIG. 31 schematically illustrates exemplary aspects of the foot controlassembly of FIG. 30 .

FIG. 32 schematically illustrates an example of an optical switch foruse in the foot control assembly of FIG. 31 .

FIG. 33 illustrates a process flow, in an embodiment, for operativelybinding the foot control to the heat unit assembly of the surgicalmicroscope system.

FIG. 34 illustrates a process flow, in an embodiment, of home screencontrols for control of the foot control assembly of the surgicalmicroscope system.

FIG. 35 schematically illustrates an example of a headrest assemblyshowing a partially transparent side view showing eyepieces secured to abinocular optics module of the microscope subassembly.

DETAILED DESCRIPTION

The present invention can be understood more readily by reference to thefollowing detailed description, examples, drawings, and claims, andtheir previous and following description. However, before the presentdevices, systems, and/or methods are disclosed and described, it is tobe understood that this invention is not limited to the specificdevices, systems, and/or methods disclosed unless otherwise specified,and, as such, can, of course, vary. It is also to be understood that theterminology used herein is for the purpose of describing particularaspects only and is not intended to be limiting.

The following description of the invention is provided as an enablingteaching of the invention in its best, currently known embodiment. Tothis end, those skilled in the relevant art will recognize andappreciate that many changes can be made to the various aspects of theinvention described herein, while still obtaining the beneficial resultsof the present invention. It will also be apparent that some of thedesired benefits of the present invention can be obtained by selectingsome of the features of the present invention without utilizing otherfeatures. Accordingly, those who work in the art will recognize thatmany modifications and adaptations to the present invention are possibleand can even be desirable in certain circumstances and are a part of thepresent invention. Thus, the following description is provided asillustrative of the principles of the present invention and not inlimitation thereof.

As used throughout, the singular forms “a,” “an” and “the” includeplural referents unless the context clearly dictates otherwise. Thus,for example, reference to “a light source” can include two or more suchlight sources unless the context indicates otherwise.

Ranges can be expressed herein as from “about” one particular value,and/or to “about” another particular value. When such a range isexpressed, another aspect includes from the one particular value and/orto the other particular value. Similarly, when values are expressed asapproximations, by use of the antecedent “about,” it will be understoodthat the particular value forms another aspect. It will be furtherunderstood that the endpoints of each of the ranges are significant bothin relation to the other endpoint, and independently of the otherendpoint.

As used herein, the terms “optional” or “optionally” mean that thesubsequently described event or circumstance can or cannot occur, andthat the description includes instances where said event or circumstanceoccurs and instances where it does not.

The word “or” as used herein means any one member of a particular listand also includes any combination of members of that list. Further, oneshould note that conditional language, such as, among others, “can,”“could,” “might,” or “can,” unless specifically stated otherwise, orotherwise understood within the context as used, is generally intendedto convey that certain aspects include, while other aspects do notinclude, certain features, elements and/or steps. Thus, such conditionallanguage is not generally intended to imply that features, elementsand/or steps are in any way required for one or more particular aspectsor that one or more particular aspects necessarily include logic fordeciding, with or without user input or prompting, whether thesefeatures, elements and/or steps are included or are to be performed inany particular embodiment.

The phraseology and terminology used herein is for the purpose ofdescription and should not be regarded as limiting. As used herein, theterm “plurality” refers to two or more items or components. The terms“comprising,” “including,” “carrying,” “having,” “containing,” and“involving,” whether in the written description or the claims and thelike, are open-ended terms, i.e., to mean “including but not limitedto.” Thus, the use of such terms is meant to encompass the items listedthereafter, and equivalents thereof, as well as additional items. Onlythe transitional phrases “consisting of” and “consisting essentiallyof,” are closed or semi-closed transitional phrases, respectively, withrespect to any claims. Use of ordinal terms such as “first,” “second,”“third,” and the like in the claims to modify a claim element does notby itself connote any priority, precedence, or order of one claimelement over another or the temporal order in which acts of a method areperformed, but are used merely as labels to distinguish one claimelement having a certain name from another element having a same name(but for use of the ordinal term) to distinguish claim elements.

Disclosed are components that can be used to perform the disclosedmethods and systems. These and other components are disclosed herein,and it is understood that when combinations, subsets, interactions,groups, etc. of these components are disclosed that while specificreference to each various individual and collective combinations andpermutation of these cannot be explicitly disclosed, each isspecifically contemplated and described herein, for all methods andsystems. This applies to all aspects of this application including, butnot limited to, steps in disclosed methods. Thus, if there are a varietyof additional steps that can be performed it is understood that each ofthese additional steps can be performed with any specific embodiment orcombination of embodiments of the disclosed methods.

The present methods and systems can be understood more readily byreference to the following detailed description of preferred embodimentsand the examples included therein and to the Figures and their previousand following description.

Turning now to FIGS. 1 and 2 , an exemplary surgical microscope system10 is shown that includes a head unit microscope assembly 20 and a footcontrol assembly 30 in operative communication with the head unitmicroscope assembly. As one skilled in the art will appreciate, the footcontrol assembly 30 can be operatively coupled to the head unitmicroscope assembly via a conventional cable run or via a wirelessconnection. As shown, the head unit microscope assembly 20 can beconfigured to selectively couple to a floor stand assembly 40 such thatthe that the head unit microscope assembly 20 can be positioned in adesired operative location by the user.

In various aspects, the exemplary surgical microscope system 10 can alsoinclude one or more of: a remote viewing assembly 50 in operativecommunication with the head unit microscope assembly; and/or a head restassembly 60 that is configured to allow a surgeon to rest their headinto a custom fit support device in order to alleviate strain on thesurgeon's neck and upper back muscles by allowing the surgeon to restthe weight of his/her head against the face piece during surgery.

Head Unit Microscope Assembly

In one aspect, and as schematically shown in FIG. 3 , the head unitmicroscope assembly 20 for the surgical microscope system can includeone or more of: a mounting adaptor 210, an XY directional stage 220, atilt drive 230, a focus drive 270; a microscope subassembly 300, and/oran illumination system 320.

In this aspect, it is contemplated that the mounting adaptor 210 of thehead unit microscope assembly 20 can be configured to operatively coupleto any existing surgical microscope floor stand, regardless of brand,which allows for upgrade of a surgical microscope's optical portion toprovide functions and benefits that are not currently available in datedprior existing surgical microscopes. In one aspect, the mounting adapter210 can comprise an elongated member that extends outwardly from the topsurface 222 of the XY directional stage 220 along a mount axis 212. Inthis aspect, the mounting adaptor can be configured to be receivedwithin a complementary bore defined in a distal mount portion 42 of thefloor stand 40. In a further optional aspect, the top surface of the XYdirectional stage 220 can define a mount port that is configured toaccept mounting adaptors that are compatible with a conventional floorstand that the user would like to use with the head unit microscopeassembly 20. In this aspect, the mount port can have a dovetail form forselective receipt of the selected mounting adaptor. Optionally, themounting adaptor 210 can be coupled to a complementary mounting post 213extending outwardly from the XY directional stage 220. In one example,one skilled in the art will appreciate that the top surface 222 candefine a plurality of bores that define a plurality of bolt patternsthat are configured to allow for the complementary receipt of plates,posts or other adaptors such that the head unit microscope assembly 20can be operatively coupled to any existing surgical microscope floorstand.

When coupled to the floor stand, the mount axis 212 of the mount adaptoris positioned in a Z axis and the XY directional stage 220 is configuredto allow for the selective movements of a distal yoke portion 21 of thehead unit microscope assembly 20 in a plane defined by the X and Y axis.Thus, during surgery, if the surgeon wants to see different anatomy orthe patient has moved, user-controlled movement of the distal yokeportion of the head unit microscope assembly 20 along the defined XYplane allows for changing the relative positioning of the microscope.

Referring to FIGS. 4 and 5 , an exemplary XY directional stage 220 isshown. As exemplary illustrated, the XY directional stage 220 includestwo linear piston drives 222, the respective piston drives 222 beingpositioned at right angles relative to each other in along respective Xand Y axis. Each piston drive 222, 222′ has an actuator 224, 224′ thatis coupled to a cradle 226, 226′ that is configured for slideablebi-axial movement along a respective X or Y axis. Further, each cradle226 is slideably mounted to an opposed pair of rods 228, 228′ thatextend between opposing wall frames 229, 229′. As one will appreciate,the respective axis of the pair of rods 228, 228′ are parallel andco-axial to the axis of movement of the respective actuator 224, 224′.

In another optional aspect, it is contemplated XY directional stage 220can further include a pair of linear potentiometers. In this aspect,each linear potentiometer would be configured to monitor the position ofthe XY directional stage 220 along a respective X or Y axis.

As exemplarily shown, the XY directional stage 220 is configured tooperate the electrically controlled and driven movement of the head unitmicroscope assembly 20 on an substantially horizontal X and Y plane.Exemplary linear piston drives 222 include, without limitation, lineardrives manufactured by are Actuonix, Firgelli, and the like. Theseexemplary linear piston drives 222 are capable of providing linearmovement with positional resistive feedback. Thus, the linear pistondrives 222 are configured to provide a signal that is indicative of“where” the respective linear drive is located within the linear pistondrive's positional range of movement and also provide a signalindicative of whether the respective linear piston drive has reached, oroptionally, is approaching a respective limit end excursion of therespective positional range of movement. As one will appreciate, suchpositional feedback can also allow for the system to be selectivelyconfigured to “recenter” the respective linear piston drives 222 alongone or more of the respective X and Y axis's positional range ofmovement to a selected or “central” position. One will appreciate, the“central” position can be any position that is selected by the operatorfor this “recenter” operation.

It will be appreciated that the XY directional stage 220 is electricallycontrolled and the exemplary linear piston drives 222 are capable ofoperating singly, to provide single directional movement along arespective X or Y axis or in simultaneous mode to provide diagonalmovement along the XY plane. As described below, the movements of the XYdirectional stage 220 can be controlled by a foot control and/or byon-screen controls as needed by the user.

The distal yoke portion 21 of the head unit microscope assembly 20includes the tilt drive 230 and the focus drive 270. Referring to FIGS.6-9 , the tilt drive 230 is configured to provide electricallycontrolled and driven angular tilt of the microscope. As shown, the tiltdrive allows for relative tilt movement head unit microscope assembly 20and that this relative tilt movement is configured to occur between thefocus drive 270 and the XY directional stage 220. One skilled willappreciate that the drive axis of the focus drive 270 is technically aZ-axis with respect to the optical viewing axis. As shown, movementalong the drive axis of the focus drive 270 is allows for the selectivemovement of the microscope closer to or further away from the patient.Thus, if the microscope is tilted to some degree, the “focus” movementalong the drive axis of the focus drive 270 needs to move along thatsame “angle,” e.g., along a common axis, to provide true focus.

As shown, the tilt drive 230 can comprise a housing 232 having a distalend 234 and a proximal end 235. The housing 232 has a pair of opposedparallel side walls 236 that define an interior cavity 237. The proximalend of the housing is fixedly mounted to a post 227 extending distallyfrom the XY directional stage 220. Adjacent the proximal end 235 of thehousing, a first axle 240 is mounted to the respective side walls 236,which first axle extends transverse to the opposed parallel side walls.Similarly, adjacent the distal end 234 of the housing, a second axle 242is mounted to the respective side walls 236, which second axle extendstransverse to the opposed parallel side walls.

As shown, the tilt drive 230 further comprises a linear piston drive 260and a drive member 244. Exemplary linear piston drive 260 includes,without limitation, linear piston drives manufactured by are Actuonix,Firgelli, and the like. These exemplary linear piston drives 260 arecapable of providing linear movement with positional resistive feedback.In this aspect, the drive member 244 comprises a first member 245 havinga proximal end 246 that defines a bore that is sized and shaped tocomplementary receive the second axle 242 of the housing. Thus, inoperation, the drive member 244 can be selectively rotated about thesecond axle 242. The drive member 244 further includes a second member247 that is integrally connected to the distal end 248 of the firstmember 245 and that extends outwardly relative to the drive member at anobtuse angle. The second member 247 has a pair of opposed parallelsecond member side walls 250 that define an interior cavity 252. Asshown, proximate the distal end 252 of the second member 247, a thirdaxle 254 is mounted to the respective second member side walls 250,which third axle 254 extends transverse to the opposed parallel sidewalls. The linear piston drive of the tilt drive is coupled to therespective first and third axles and extends at least partially withinthe interior cavity 237 of the housing 232. In operation, the selectiveactivation of the linear piston drive 260 allows for the selectiverotation of the drive member 244 about the axis defined by the secondaxle 242.

In another optional aspect, it is contemplated that the tilt drive 230can be configured to generate a signal that is indicative of theposition of the linear piston drive 260 and/or the amount of “tilt,”e.g., the rotational position of the drive member relative to anelongate axis of the housing of the tilt drive 230. In operation, it isoptionally contemplated that the system can provide at least one, or aplurality of, pre-determined tilt positions that can be selected by theoperator for respective operative procedures. In various non-limitingexemplary aspects, it is contemplated that such a signal can begenerated by a rotary potentiometer or via the use of a conventionalMEMS inclinometer.

In one optional aspect, it is contemplated the tilt drive 230 canfurther include at least one rotary positional sensor 261. In thisaspect, a first gear 262 can be operatively coupled to the proximal endof the first member of the drive member such that it is configured torotate about an axis co-axial to the axis of the second axle of the tiltdrive. A second gear 264 can be mounted on to a fourth axle mountedwithin the interior cavity of the wall members. A continuous belt, notshown, operably connects the first and second gears. Further, in thisaspect, it is contemplated that rotational potentiometers 263 coupled tothe respective first and second gears can be configured to monitor therotational position of the drive member relative to an elongate axis ofthe housing of the tilt drive 230. In operation, as the tilt drive 230is actuated, the coupled shafts are rotated, relative to the amount oftilt, which is then seen by the potentiometer as a variable resistiveload. In this aspect, a conventional ADC circuit reads the value andgenerative a signal indicative of the relative amount of tilt.

In a further optional aspect, a MEMS inclinometer can be coupled to thetilt drive 230. In one example, the MEMS inclinometer can be an IMU(Inertial Movement Unit) manufactured by Murata Electronics, which is asolid-state device IC with digital communication capabilities. The MEMSinclinometer is configured to generate a signal indicative of therelative amount of tilt of the tilt drive that is relative to Earth'sgravity.

The drive member 244 further defines a mounting surface 249 positionedon a portion of the proximal end of the first member 247. As shown inthe figures, the focus drive 270 is mounted to the mounting surface 249.The focus drive 270 has a housing 272 having a proximal end 274 and adistal end 276 and parallel opposing walls that define an interiorcavity 278. In the exemplary figures, a distal portion 280 of thehousing 272 is mounted to the mounting surface 249 of the drive member244. As one will appreciate, as the drive member 244 is operativelyrotated relative to the elongate axis of the housing of the tilt drive230, the housing 272 would be complementarily rotated in a plane thatbisects the elongate axis of the housing 232 of the tilt drive 230.

The focus drive 270 includes a linear actuator drive 280 that is mountedwithin the interior cavity 278 of the housing and extends along a driveaxis that is co-axial to the elongate axis of the housing. Exemplarylinear actuator drives 280 include, without limitation, linear actuatordrives manufactured by are Actuonix, Firgelli, and the like. Theseexemplary linear actuator drives 280 are capable of providing linearmovement with positional resistive feedback. As previously described,the focus drive allows for the electrically controlled and drivenbi-axial movement of the microscope along an axis that is defined by theposition of the tilt drive 230. On skilled in the art will appreciatethat the axis for focus is with respect to the optical axis and is notnecessarily co-incident with the mount axis. It will be appreciated thatthe focus drive 270 can be controlled by a foot control and/or byon-screen controls as needed by the user.

The linear actuator drive 280 is configured to provide a signal that isindicative of “where” the linear actuator drive 280 is located withinthe linear piston drive's positional range of movement and also providea signal indicative of whether the linear actuator drive 280 hasreached, or optionally, is approaching a respective limit end excursionof the positional range of movement. As one will appreciate, suchpositional feedback can also allow for the system to be selectivelyconfigured to “recenter” the linear actuator drive 280 along the driveaxis's positional range of movement to a selected or “central” position.One will appreciate, the “central” position can be any position that isselected by the operator for this “recenter” operation.

The proximal end of the linear actuator drive is mounted within theinterior cavity of the housing at the proximal end of the housing. Inoperation, portions of the actuator of the linear actuator drive areconfigured to extend through an opening 279 defined in a distal end ofthe housing. As one will appreciate, the actuator is configured forbi-axial movement along a defined drive axis that is co-axial to theelongate axis of the housing of the focus drive 270.

The focus drive 270 further includes a mount member 290 that has a firstmount 292 that is connected to, and extends transversely too, the distalend of the actuator of the linear actuator drive. The mount memberfurther includes a second elongate mount 294 that is connected to adistal edge of the first mount such that the second elongate mount ispositioned transverse to the first mount and has a longitudinal axisthat is parallel to the elongate axis of the housing of the focus drive270. As one will appreciate, selective actuation of the focus driveallows for the movement of the second elongate mount relative to thedistal end of the housing of the focus drive 270 and along a plane thatbisects the drive axis of the actuator.

In another optional aspect, it is contemplated the focus drive 270 canfurther include a positional sensor 296, such as, for example andwithout limitation, a linear potentiometer. In this exemplary aspect, anelongate touch pad 297 can be mounted onto an exterior surface of a wallof the housing of the focus drive 270 that is positioned in spacedopposition to an inwardly facing exterior surface of the second elongatemount. Further, a pin 298, which extends outwardly from the inwardlyfacing exterior surface of the second elongate mount, can be configuredto selectively contact the touch pad such that the pressure contact ofthe pin against the touch pad can be sensed. Thus, the relative lineardistance that the second elongate mount moves relative to the distal endof the housing of the focus drive 270 can be sensed and a signal can begenerated that is indicative of the position of the second elongatemount relative to the distal end of the housing of the focus drive 270.

Referring now to FIGS. 3 and 10 , the microscope subassembly 300 isconnected to the outwardly facing exterior surface of the secondelongate mount. The microscope subassembly 300 further has a housing 301into which a zoom optics module 302, a zoom drive 304, and an objectivelens 306 are mounted. As shown in the figures, the zoom optics module302 is positioned proximal to the zoom drive 304 and the distal mostobjective lens 306. The respective zoom optics module 302, zoom drive304, and objective lens 306 are conventional. Further, it iscontemplated that the microscope subassembly 300 can further include abinocular optics module 308 that is conventional and is configured toconventionally mount thereto the proximal end of the zoom optics module.

Referring to FIG. 11 , the microscope subassembly 300 further includesthe illumination system 320, which comprises three light sources 322 forillumination of the targeted tissue area. As shown, one of the lightsources 322 is a central or coaxial light source 321 and the remainingpair of light sources are off-axis or oblique lights sources 323. It iscontemplated that the intensity of at least one of the light sources canbe controlled to fine tune the ratio of light between the coaxial lightsource and the pair of oblique light sources. Optionally, it iscontemplated that the intensity of each of the light sources can becontrolled to fine tune the ratio of light between the coaxial lightsource and the pair of oblique light sources. In a further optionalaspect, it is contemplated that the color temperature and/or colorrendering index (CRI) of one or more of the respective light sources 322can be selectively controlled.

In this aspect, the user control of the ratio of light from therespective coaxial and oblique light source is beneficial in surgicalcontexts. For example, in eye surgery, coaxial light illuminationprovides desired levels of red reflex for cataract surgery andillumination penetration, while oblique light illumination can providedesired levels of depth perception and edge detection. For example, andwithout limitation, the user can select the ratio of light between thecoaxial light source and the pair of oblique light sources to beapproximately 80% of the light impacting the targeted tissue to from thedivergent coaxial light beam and the remaining 20% from the pair ofdivergent oblique light beams.

In operation, it is further contemplated that when a user initiates theillumination system 320 of the microscope subassembly 300, the user canmanually adjust the ratio of light between the coaxial light source 321and the pair of oblique light sources 323 to obtain a user preferencelight ratio level setting. In an optional aspect, it is furthercontemplated that the user can select to save the user preference lightratio level setting in the control subsystem 500 such that when the userresets the illumination system 320, the user preference level setting isrecalled. As one will also appreciate, it is contemplated that when auser has set or selected a desired ratio of light between the coaxiallight source 321 and the pair of oblique light sources 323, the user cansubsequently selectively change, i.e., increase and/or decrease, theoverall light intensity supplied the illumination system 320 whilemaintaining the selected light ratio level setting.

In one aspect, it contemplated that the respective light sources 322 canhave a high CRI level. In this aspect, for various embodiments, the CRIlevel of the respective light sources 322 can be at least 70, preferablyat least 80, more preferably at least 90, with a desired CRI of at least95. In other aspects, for various embodiments, the CRI level of therespective light sources 322 can be between 70 and 99.9, preferablybetween 80 and 99.9, more preferably between 90 and 99.9, still morepreferably between 95 and 99.9, with a desired CRI between 97 and 99.Generating a high CRI level from the respective light sources 322 aidsin providing an accurate color representation, which is difficult inLEDs as conventional LEDs generate peak colors in the blue, green andred spectrums as a result of the conventional use of blue, green and redbulbs is the respective LED.

In ophthalmologic surgery procedures, red reflex, which is incidentlight that is reflected off of the patient's retina, allows a surgeon tovisualize clear and semi-clear tissues in the eye. Since the retina ofthe patient is full of blood, the light that is most reflected would bein the red spectrum of light. In one aspect, the respective lightsources 322 can be selected or otherwise configured to generate a highpercentage level of normalized radiant power in the red spectrum; i.e.,it is preferred that the spectrum of light generated by the respectivelight sources 322 be biased toward providing a peak level of thepercentage level of normalized radiant power about the red spectrum. Inthis aspect, it is preferred that the respective light sources 322generate a peak percentage level of normalized radiant power havingradiation with wavelengths between about 600 and 700 nm; and preferablyabout 650 nm.

In a further optional aspect, because different pigment eyes responddifferently, it is contemplated that the illumination system 320 of themicroscope subassembly 300 be configurable by the user to adjust thecolor temperature and/or spectral makeup of the total light generated bythe coaxial light source 321 and the pair of oblique light sources 323to generate a desired spectrum of incident light in order to obtain alevel of desired red reflex from the light illumination incident on thepatient's eye.

In yet another exemplary aspect, it contemplated that the respectivelight sources 322 can be selected or can be otherwise configured togenerate a color temperature of that is less than about 4500K,preferably less than 4000K, more preferably less than 3800K, with adesired color temperature of about 3500K. In other aspects, for variousembodiments, the color temperature of the respective light sources 322can be between 2500K and 4500K, preferably between 3000K and 4000K, morepreferably between 3100K and 3900K, with a desired color temperature ofbetween 3300K and 3600K. Generating a desired color temperature from therespective light sources 322 in the identified ranges aids in providingan accurate color representation while minimizing the intensity of thelight sensed by the patient.

Referring to FIG. 12 , prior art illumination systems typically use twobeams of coaxial illumination and one beam of oblique illumination. Asillustrated in FIGS. 13 and 14 , prior art illumination systems use abeam of coaxial illumination for each of the respective left and righteye optical axis. An accurate representation of the illumination fromthe prior art illumination systems is shown in FIG. 12 , whichillustrates overlapping coaxial illumination relative to the obliqueillumination. For eye surgery, in the illumination environment providedby these prior art illumination systems, only the area in which the twocoaxial lights overlap is appropriate red reflex directed to both of thesurgeon's eyes. Thus, in this context and for these prior artillumination systems, if the patient's iris is outside of thisoverlapping area, the surgeon either receives appropriate red reflexalong only one optical pathway, or no red reflex at all.

In other prior art illumination systems and as shown in FIG. 13 , thelight energy passes through the objective lens that resultantly providessome general “focused light” or convergence. Optionally, as shown inFIG. 14 , the prior art illumination system uses collimated light, onefor each optical pathway—the left and the right eye, that does not passthrough the objective lens and does not tend to converge. In thissystem, a third light beam is directed at the targeted tissue from anoblique angle to provide for oblique illumination is directed in fromabout an eight-degree oblique angle.

In one aspect of the illumination system of the present invention, andas shown in FIGS. 15A, 15B and 16 , the central or coaxial light sourceforms a beam of divergent light that does not pass through the objectivelens 306 and that is configured or otherwise sized to fill the targetedtissue area with light. In this aspect, the beam of divergent lightemits from the center of the surgeon's view, i.e., centered between thesurgeon's left and right optical pathways. As shown, the divergent angleof the central or coaxial light source allows for a comparableillumination area that is relative to the oblique illumination at thefocal plane.

The central or coaxial light source provides a wider dispersion of lightenergy on the patient's retina with less concentration when compared tothe prior art illumination systems. This wider dispersion of lightenergy on the patient's retina allows for more of the interior region tobe illuminated while also provides for evenly dispersed light energyacross the targeted tissue, which provides excellent red reflex effectthat is less dependent on the angle or axis of the patient eye. Thecoaxial light source illumination can fill the entire targeted area ofthe illumination spot size at the focal plane, which allows for the redreflex area generated by the illumination system, in contrast to theprior art illumination systems, to substantially mirror the illuminatedtissue at the focal plane. Thus, in eye surgery, no matter where thepatient's eye is during surgery, as long as the patient's eye isreceiving illumination from the illumination system, the red reflex willbe visualized by the surgeon.

Further, it is contemplated that the wider dispersion of light energy onthe patient's retina provided by the illumination system 320 aids inminimizing patient photophobia, which can cause patient discomfort,while also minimizing patient phototoxicity, which can result inundesired light-induced retinal tissue damage. Because the exemplifiedprior art illumination systems generally all use light sources thatnarrowly disperse light energy impacting on the patient's retina duringsurgery, the patient's suffer discomfort from the perceived lightinduced “hot” or “bright” spot during surgery. Adversely, the patientmay also suffer tissue damage due the adverse effects of the narrowlydispersed light energy impacting of the targeted eye tissues over thecourse of the surgery. As suggested, the large point source of theillumination beams generated by the illumination system 320 and the lowrelative intensity of the divergent oblique beams contributes toenhanced patient comfort and a minimization of potential eye tissuedamage.

In a further aspect, the divergent beam of light generated by thecentral or coaxial light source 323 of the illumination system can beselectively decreased in diameter when desired by the user. In thisdecrease in diameter does not increase the intensity of the light energyimpacting the targeted tissue, but rather, the illumination systemfurther includes a user modulated clip or iris, positioned distally fromthe central or coaxial light source, to generate the reduced diameter ofthe divergent light beam. The clip or iris can be controlled manuallyvia a coupled knob or can be motorized via a servo motor or othermechanism suitable for actuating the diaphragm of the clip or iris. Inoperation, the selective reduction in the diameter of the divergentlight beam generated by the central or coaxial light source can aid inreducing excessive glare and light reflecting from the patient's sclera.

As one skilled in the art will appreciate, oblique illumination is theprimary creator of contrast, depth perception, and edge detection for asurgical microscope. illumination coming from an oblique angle createsshadows and helps the user perceive where structure and anatomy are withrelation to each other. As illustrated, the illumination system uses thepair of light sources to provide the desired off-axis or oblique lightssources. The oblique and divergent light beams 321 that are generated byeach of the oblique lights sources and angled at a desired angle ofincidence β, relative to the optical axis. In one aspect, the desiredangle of incidence β is between about 5 to 15 degrees, about 8 to 12degrees or about 10 degrees. Optionally, in other aspects, the desiredangle of incidence β can be at least 9 degrees or at least 10 degrees.In a further aspect, and as illustrated in FIG. 10 , the pair of lightsources that provide the desired off-axis or oblique lights sources canbe positioned on opposite sides of the central, coaxial light source.

In this aspect, because the oblique and divergent light beams are nothaving to assist with coaxial illumination, they can be offset atgreater incident angles than prior art illumination systems, whichprovides for improved depth perception and edge detection. By havingoblique and divergent light oblique beams, the illumination system canprovide contrast from both sides also improving the overall effect.

In operation, the central or coaxial light source 321 and the remainingpair of off-axis or oblique lights sources 323 use large light emittingsurfaces (LES) that are configured to create a less concentrated virtualimage on the patient retina. Exemplary LEDs having large light emittingsurfaces can include, without limitation, Citizen's Model No.CLU048-1818C4-303H5K2; Citizen's Model No CLU048-1212C4-303H7K4;Bridgelux Inc.'s Model No. BXRC-30E4000-D-73, and the like.

In one aspect, it is desired that each of the central or coaxial lightsource 321 and the remaining pair of off-axis or oblique lights sources323 use large light emitting surfaces (LES). Light generated from aconventional “small” point source, such as a filament or smaller LED,generates an undesirably high light intensity that is incident on thepatient eye tissue, which can be painful and/or harmful. As identifiedherein, using a LES LED for each of the central or coaxial light source321 and the remaining pair of off-axis or oblique lights sources 323generates a wider, more dispersed, and somewhat diffused light sourcethat provides adequate illumination for the surgical procedure, butgenerates less incident light energy per measured surface area of thesubject tissue, which can provide better patient outcomes and comfortlevels.

In various exemplary aspects, it is contemplated that each of the eachof the light emitting surfaces LEDs can have a light emitting surfacethat are greater than about 20.0 mm², which can create a total lightsource from the central or coaxial light source 321 and the remainingpair of off-axis or oblique lights sources 323 that is greater thanabout 60 mm², or optionally, each of the light emitting surfaces LEDscan have a light emitting surface that are greater than about 30.0 mm²,which can create a total light source of greater from the central orcoaxial light source 321 and the remaining pair of off-axis or obliquelights sources 323 that is greater than about 90 mm². Optionally it iscontemplated that each of the each of the light emitting surfaces LEDscan have a light emitting surface that are greater than about 35.0 mm²,which can create a total light source of from the central or coaxiallight source 321 and the remaining pair of off-axis or oblique lightssources 323 that is greater than about 105 mm², or optionally, each ofthe light emitting surfaces LEDs can have a light emitting surface thatare greater than about 38.5 mm², which can create a total light sourcefrom the central or coaxial light source 321 and the remaining pair ofoff-axis or oblique lights sources 323 that is greater than about 115mm².

In a further optional aspect, each of the light emitting surfaces LEDscan have a light emitting surface that are sized to create a total lightsource from the central or coaxial light source 321 and the remainingpair of off-axis or oblique lights sources 323 that is between about 80to about 140 mm², and preferably between about 90 to about 130 mm².Compared to a typical LED or bulb filament that forms a light source inthe 10 mm² or less, the light sources used in the illumination systemhelp to reduce patient stress and photophobia. In an additional aspect,large light emitting surfaces LEDs used in the illumination system alsogenerate a more diffused light coming from different angles that are notcollimated or focused such as the light used in prior art illuminationsystems.

Each of the large light emitting surfaces LEDs used in the illuminationsystem comprise a plurality of individual LEDs arranged in an array. Forexample, and without limitation, the plurality of individual LEDsarranged in an array can be greater than 50 individual LED pointsources, or greater than 100 individual LED point sources. This resultsin a light source that provides for a plurality of less intenseindividual point sources that are configured to create a plurality ofdiffused multiple dispersed light rays.

In this aspect, the individual LEDs forming the respective large lightemitting surfaces LEDs can allow for color adjustment of the generatedlight beam. In this aspect, because of the large number of individualLED point sources that form the large array, certain groups of LEDs canbe of a certain color. Further, it is contemplated that selective groupsof individual LED point sources can be independently controlled tocontrol the overall color effect. For example, selective groups ofindividual LED point sources can be independently controlled off-onand/or bright-dim, to control overall color effect. Thus, the user couldadjust color temperature of the light sources via an interface to allowthe user to scale the desired color temperature to a desired level.

In one aspect and referring to FIG. 17 , the head unit microscopeassembly 20 is configured to house a control subsystem 500 for thesurgical microscope system. Thus, in this exemplary aspect, it iscontemplated that the head unit microscope assembly 20 can be configuredto contain the electronic controls, computer systems, programing, etc.necessary for operation of the head unit microscope assembly. Thus, inthis aspect, it is contemplated that the control subsystem 500 of thehead unit microscope assembly 20 can include a processing system havingat least one processor 502 and at least one memory 504, which can becoupled to a volatile or non-volatile memory containing a database forstoring information related to the operation of the surgical microscopesystem. The memory 504 being configured to contain instructions that,when executed by the processor, are operative to perform the essential,recommended and/or optional functions in various embodiments of thesurgical microscope system 10 described herein. Is this aspect, thecontrol subsystem 500 has at least one memory that is configured tostore program instructions such that, in operation, the at least onememory of the control subsystem 500 is configured to store programinstructions that, when executed, cause the surgical microscope assemblyto perform the required operations. Optionally, if the floor stand thatthe head unit microscope assembly is retrofitted thereto containsoperational electronics, the head unit microscope assembly can beconfigured to selectively communicate with the floor stand electronics.

To regulate the operation of the surgical microscope system 10, thecontrol subsystem 500 can include input devices 512 (such as sensors)and output devices 514 (such as actuators) that are operatively coupledto the processor(s) 502. The control subsystem 500 includes a memory 504that is in communication with the processor(s) 502 and may also includeother features such as limiters, conditioners, filters, formatconverters, or the like which are not shown to preserve clarity. One ormore operator input devices 512 can also be coupled to the controller502 to provide corresponding operator input to adjust/direct one or moreaspects of surgical microscope system operation. Exemplary input devicescan include, without limitation, a keyboard, mouse, pen, voice inputdevice, gesture input device, foot control device, and/or touch inputdevice, or any other suitable input device. The control subsystem 500can further include one or more output devices 514 that are coupled tothe controller 502, such as a display, printer, and/or speakers, or anyother suitable output device. In other embodiments, however,computer-readable communication media may include computer-readableinstructions, program modules, or other data transmitted within a datasignal, such as a carrier wave, or other transmission. Optionally, thecontrol subsystem 500 can also include an audible alarm, warninglight(s), or the like (not shown) can also be coupled to the controller502 that each respond to various output signals from controller 502.

In additional detail, the control subsystem 500 is configured forimplementing certain systems and methods for operating a surgicalmicroscope system in accordance with certain embodiments of thedisclosure. The processor(s) 502 is configured to execute certainoperational aspects associated with implementing certain systems andmethods described herein. The processor(s) 502 can be implemented andoperated using appropriate hardware, software, firmware, or combinationsthereof. Software or firmware implementations may includecomputer-executable or machine-executable instructions written in anysuitable programming language to perform the various functionsdescribed. In some examples, instructions associated with a functionblock language may be stored in the memory 504 and executed by theprocessor(s) 502.

As one will appreciate, the memory 504 can be used to store programinstructions, such as instructions for the execution of the methodsillustrated herein or other suitable variations. The memory 504 caninclude, but is not limited to, an operating system 516 and one or moreapplication programs or services for implementing the features andembodiments disclosed herein. Such applications or services may includeremote units 520, such as the remote viewing assembly described below,for executing certain systems and methods for controlling operation ofthe surgical microscope system (e.g., semi- or full-autonomouslycontrolling operation of the remote viewing assembly.

The instructions are loadable and executable by the processor(s) 502 aswell as to store data generated during the execution of these programs.Depending on the configuration and type of the control subsystem 500,the memory 504 may be volatile (such as random-access memory (RAM))and/or non-volatile (such as read-only memory (ROM), flash memory,etc.). In some embodiments, the memory devices may include additionalremovable storage 507 and/or non-removable storage 508 including, butnot limited to, magnetic storage, optical disks, and/or tape storage.The disk drives and their associated computer-readable media may providenon-volatile storage of computer-readable instructions, data structures,program modules, and other data for the devices. In someimplementations, the memory 504 includes multiple different types ofmemory, such as static random-access memory (SRAM), dynamic randomaccess memory (DRAM), or ROM.

The memory 504, the removable storage 507, and the non-removable storage508 are all examples of computer-readable storage media. For example,computer-readable storage media may include volatile and non-volatile,removable and non-removable media implemented in any method ortechnology for storage of information such as computer-readableinstructions, data structures, program modules or other data. Additionaltypes of computer storage media that may be present include, but are notlimited to, programmable random access memory (PRAM), SRAM, DRAM, RAM,ROM, electrically erasable programmable read-only memory (EEPROM), flashmemory or other memory technology, compact disc read-only memory(CD-ROM), digital versatile discs (DVD) or other optical storage,magnetic cassettes, magnetic tapes, magnetic disk storage or othermagnetic storage devices, or any other medium which may be used to storethe desired information and which may be accessed by the devices.Combinations of any of the above should also be included within thescope of computer-readable media.

The control subsystem 500 can also include one or more communicationconnections 510 that may allow a control device (not shown) tocommunicate with devices or equipment capable of communicating with thecontrol subsystem 500. Connections may also be established via variousdata communication channels or ports, such as USB or COM ports toreceive cables connecting the control subsystem 500 to various otherdevices on a network. In one embodiment, the control subsystem 500 caninclude Ethernet drivers that enable the control subsystem 500 tocommunicate with other devices on the network. According to variousembodiments, communication connections 510 may be established via awired and/or wireless connection on the network.

It is contemplated that the control subsystem 500 can be comprised ofone or more components that may be configured as a single unit ordistributed among two or more units. The processor(s) 502 and/or thememory 504 can be combined in a common integrated circuit, defined byseparate circuitry, or comprised of one or more other component types ofa solid state, electromagnetic, optical, or different variety as wouldoccur to those skilled in the art. The control subsystem 500 may includeanalog circuitry, digital circuitry, and/or a hybrid combination of bothof these types. In one aspect, the control subsystem 500 is configurablefor to reside within the head unit microscope assembly.

In one form, the control subsystem 500 is of the programmable varietythat executes algorithms and processes data in accordance with operatinglogic that is defined by programming instructions (such as software orfirmware). Alternatively, and/or additionally, operating logic for thecontrol subsystem 500 is at least partially defined by hardwired logicor other hardware. In one particular form, the control subsystem 500 canbe configured to operate as a Full Authority Digital Engine Control(FADEC); however, in other embodiments it may be organized/configured ina different manner as would occur to those skilled in the art. Asexemplarily illustrated in the flowcharts of the present application, itis contemplated the control subsystem 500 is programed to executealgorithms and to process data in accordance with the operating logicthat is defined by programming instructions and or steps illustrated inthe associated figures.

It is further contemplated that the control subsystem 500 may includeone or more industrial control systems (ICS), such as, for example,Supervisory Control and Data Acquisition (SCADA) systems, distributedcontrol systems (DCS), and programmable logic controllers (PLCs), orother suitable control systems and/or control features without departingfrom the disclosure.

The control subsystem 500 can also include a number of sensors toprovide input to controller 502. Some of these exemplary inputs areillustrated in the figures and include sensors or inputs generated bythe respective XY directional stage 220, tilt drive 230, focus drive240; microscope subassembly 300, and/or an illumination system 320.

Remote Viewing Assembly

Referring to FIGS. 19-20 , the remote viewing assembly 50 is inoperative communication with the head unit microscope assembly 20 andcan comprise a camera assembly 400 that is mountable between thebinocular optics module 308 and the zoom optics module 302. In thisaspect, the camera assembly 400 comprises an opposed pair of highresolution cameras 402 that are configured to produce a left and right“view” of the image in the microscope, which are subsequently combinedand displayed on a remote 3D monitor 404. In one exemplary aspect, andnot intended to be limiting, each camera can comprise a ⅓ inch CCD videocamera. Exemplary cameras can include, without limitation, Sony's ModelNos. MCC-1000MD and MCC-1000MD; Panasonic's Model No. GP-UH532;Hitachi's Model No. HV-UHD301; Omron Sentech Co, Ltd. Model No.STC-HD213DV camera, and the like.

A user can use passive 3D glasses to perceive the displayed 3D image.Alternatively, the remote viewing assembly 50 is configured to allow forthe user to use the conventional binocular view of the microscope toview the image concurrently with the view of the image being presentedon the remote 3D monitor.

The respective opposed pair of high resolution cameras 402 are eachindividually adjustable along their individual X, Y, and Z axis andallow for rotational adjustment of the respective cameras to allow thedesired alignment of the respective left and right images.

Referring now to FIG. 21 , for each high resolution camera 402, the Zaxis can be adjusted by the actuation of a Z axis assembly in which themovement of a screw axially move a drive block, dependent upon thedirection the screw is rotated. At least one spring is provided thatprovides a desired level of compression against the spring to minimizeany slack or play in the mechanics. Similarly, and referring to FIG. 26, the respective X and Y axis can be adjusted by the actuation of a XYaxis assembly in which the movement of respective screws axially moverespective drive blocks, dependent upon the direction the respectivescrews are rotated. At least one spring is provided for each respectiveX and Y axis to provide a desired level of compression against thespring to minimize any slack or play in the mechanics. As shown, the XYaxis assembly includes a fixed block that is configured to attach to thedrive block of the Z axis assembly.

Further, as shown in FIG. 23 and with respect to the desired rotationaladjustment of the respective cameras, the Y slide of the XY assembly isfixed to the outer race of a ball bearing. In this aspect, a camera 402and rotation plate are configured to be connected to the inner race ofthe ball bearing. In operation, when the desired rotational adjustmentof the camera and rotation plate is accomplished, a rotation lock screwcan be tightened to fix the camera and rotation plate relative to theoperably coupled Y slide.

In one aspect, the remote viewing assembly 50 can use the control system500 of the surgical microscope system to operate and or control theremote viewing assembly. Thus, in this exemplary aspect, it iscontemplated that the head unit microscope assembly can be configured tocontain the electronic controls, computer systems, programing, etc.necessary for operation of the head unit microscope assembly and theremote viewing assembly.

Optionally, and as shown in FIGS. 18 and 20 , the remote viewingassembly 50 can be configured to house a control subsystem 600 that isseparable from the control subsystem 500 of the surgical microscopesystem. Thus, in this exemplary aspect, it is contemplated that theremote viewing assembly 50 can be configured to contain the electroniccontrols, computer systems, programing, etc. necessary for operation ofthe remote viewing assembly. Thus, in this aspect, it is contemplatedthat the control subsystem 600 of the remote viewing assembly caninclude a processing system having at least one processor 602 and atleast one memory 604, which can be coupled to a volatile or non-volatilememory containing a database for storing information related to theoperation of the surgical microscope system. The memory containinginstructions that, when executed by the processor, are operative toperform the essential, recommended and/or optional functions in variousembodiments of the remote viewing assembly described herein. Is thisaspect, the processing system has at least one memory that is configuredto store program instructions such that, in operation, the at least onememory of the processing system is configured to store programinstructions that, when executed, cause the surgical microscope assemblyto perform the required operations.

In a further aspect, it is contemplated that the respective opposed pairof high-resolution cameras 402 can be adjusted along their respectiveindividual X, Y, and Z axis, and rotational axis to allow the desiredalignment of the respective left and right images via an automatedsystem. In one aspect, such an automated system could include the use ofa feducial or special target for the respective opposed pair ofhigh-resolution cameras. Then the processor of the control subsystem 600would analyze the images received from the respective cameras andinstruct actuators or electrical motors, instead of the previouslydescribed screws, to affect the desired X, Y, and Z axis, and/orrotational axis adjustments.

In operation, a method for such an automated system could include:placing a special target reticle or feducial under the scope in focus athigh magnification; centering the target reticle or feducial in thevisual field, looking through the binocular optics module 308;initiating an auto-align function on the processor of the controlsubsystem 600; analyzing the incoming left and right video data streamsvia the processor of the control subsystem 600; instructing therespective actuators or electrical motors, via the processor of thecontrol subsystem 600, to effect the desired X, Y, and Z axis, and/orrotational axis adjustments while concurrently analyzing the left andright video data streams until the respective target reticle or feducialwere aligned to specification and in focus.

Foot Control Assembly

In one aspect, and referring to FIGS. 30-32 , the foot control assembly30 can operate as the primary control interface for the head unitmicroscope assembly 20. In various aspects, the foot control assembly 30is configured to allow a surgeon to control functions of the head unitmicroscope assembly 20 with their feet. Since eye surgery is done withthe surgeon sitting down, their hands are sterile and holdinginstruments, the instruments are generally inserted into the patient'seye, it is very undesirable to have to retract the instruments, lay themdown, operate the function of the microscope as needed, and then resumesurgery. Having to take instruments in and out of the eye incisionsexcessively does not optimize surgical outcomes for the patient. Also,breaking sterility for the surgeon is a possibility if they have tomanipulate some function of the head unit microscope assembly 20. Havinga simple remote control via foot actions provides a great way to controlfeatures of the head unit microscope assembly 20, such as, for example,XY directional stage 220, tilt drive 230, and/or the focus drive 270movements, zoom and illumination controls, etc.

In one aspect, it is contemplated that the foot control assembly 30 cancomprise a wireless, battery operated device that is configured toreduce cord clutter in an operating room and can further have controlswitches that are positioned in a conventional surgical control layout.In this aspect, and as shown in FIGS. 31 and 32 , it is contemplatedthat the control switches for the foot control assembly 30 can compriseat least one of hall effect (magnetic) and/or optical switches 31 forincreased surgical reliability.

Referring to FIG. 31 , it is further contemplated that the foot controlassembly 30 can comprise at least one alarm module 32. In this aspect,the alarm module 32 can be configured to activate upon when one or moreof the XY directional stage 220, tilt drive 230, and/or the focus drive270 approaches or reaches a range of movement limitation, an “end ofexcursion” limitation, for the respective XY directional stage 220, tiltdrive 230, and/or a focus drive 270. For example, in this aspect it iscontemplated that, if one or more of the pair of linear potentiometerssenses that the operational movement of the XY directional stage 220 isapproaching or has reached a range of movement limitation of the XYdirectional stage 220, such that further movement of the XY directionalstage 220 would be prohibited along a desired X and Y axis, the controlsubsystem 500 of the head unit microscope assembly 20 would send asignal to actuate the alarm module 32 of the foot control assembly 30.In this example, the actuated alarm module 32 would act to inform thesurgeon that they have reached the limit of the range of movement of theXY directional stage 220 along at least one of the respective X and Yaxis of movement.

Similarly, if at least one rotational potentiometers 263 of the tiltdrive 230 coupled to the respective first and second gears senses thatthe operational movement of the tilt drive 230 is approaching or hasreached a range of movement limitation of the tilt drive 230, such thatfurther rotational movement of the drive member relative to an elongateaxis of the housing of the tilt drive 230 would be prohibited, thecontrol subsystem 500 of the head unit microscope assembly 20 would senda signal to actuate the alarm module 32 of the foot control assembly 30.In this example, the actuated alarm module 32 would act to inform thesurgeon that they have reached the limit of the rotational movement ofthe drive member relative to an elongate axis of the housing of the tiltdrive 230.

In yet another optional aspect, if the positional sensor 296 of thefocus drive 270 senses that the operational movement of the focus drive270 is approaching or has reached a range of movement limitation of thefocus drive 270, such that further axial movement of the focus drive 270would be prohibited along the focus drive axis, the control subsystem500 of the head unit microscope assembly 20 would send a signal toactuate the alarm module 32 of the foot control assembly 30. In thisexample, the actuated alarm module 32 would act to inform the surgeonthat they have reached the limit of the range of movement of the focusdrive 270 along its axis of movement.

It is contemplated that the range of movement limitations for therespective XY directional stage 220, tilt drive 230, and/or the focusdrive 270 can be selectively set in the control subsystem 500.Optionally, the range of movement limitations for the respective XYdirectional stage 220, tilt drive 230, and/or the focus drive 270 can bepre-set in the control subsystem 500. It is further contemplated thatthe operator can instruct the control subsystem 500 to not actuate thealarm module 32 of the foot control assembly 30 if an end of excursionlimitation is reached in any or respective ones of the XY directionalstage 220, the tilt drive 230, and/or the focus drive 270.

As described herein in various optional embodiments, if any of the XYdirectional stage 220, tilt drive 230, and/or the focus drive 270 hasend limit detection as previously mentioned, and if the previouslydescribed light illumination controls have end limits as well, such asan off to full illumination to off function, it is feasible to haveaudible and tactile feedback to the user when an end-limit isreached—such feedback can be selectively tied to particular movementfunctions or can be provided for any or all of the movement functionsdescribed. In this aspect, when a “limit” is reached for a particularmovement function, a vibratory motor in the foot control assembly 30could give feedback to the user that an end-limit has been reached asthe physician is attempting try to drive the function beyond therespective “end of excursion” limitation. Optionally, an audible beep ortome could also be provided to give feedback to the user that anend-limit has been reached as the physician is attempting try to drivethe function beyond the respective “end of excursion” limitation. Thevibratory and or audible warning feature allows the physician to receivethe necessary “end of excursion” limitation feedback without having tolook up from the microscope.

As shown in FIG. 31 , it is contemplated that the alarm module 32 cancomprise at least one of an audible alarm module 33, which is configuredto provide an audible alarm notice to the user upon actuation, and/or atactile alarm module 34, which is configured to provide a tactile alarmnotice to the user, such as the exemplified vibrational alarm, uponactuation.

It is further contemplated that the alarm module can provide differenttactile and/or sound indication to the operator depending upon which ofthe respective XY directional stage 220, tilt drive 230, and/or thefocus drive 270 has triggered the control subsystem 500 to actuate thealarm module 32. This, in this exemplary aspect, one will appreciatethat the operator can intuit which respective end of excursionlimitation has been reached by the generated sound/feel of the alarmmodule 32.

In addition to a conventional power switch and because the foot controlassembly 30 can be configured to be battery operated for wirelessfunctionality, it is contemplated that the foot control assembly 30 canbe configured to selectively switch to a low power standby mode and/or apower off mode when not in operation to preserve power. In this aspect,the foot control assembly 30 can be configured to switch to the lowpower standby mode and/or the power off mode when a desired inactivitytime limit has elapsed in which none of the conventional controlswitches of the foot control assembly 30 has been actuated. For example,if none of the control switches of the foot control assembly 30 wasactuated for a system selected period of inactivity, or an operatorselected period of inactivity, the foot control assembly 30 would switchto the low power standby mode and/or the power off mode.

As shown in FIG. 19 , it is optionally contemplated that the footcontrol assembly 30 can comprise at least one shock sensor module 36that is configured to allow the operator to move the foot controlassembly 30 to a powered-up mode from either the low power standby modeand/or the power off mode by simply moving or otherwise jarring the footcontrol assembly. It this aspect, the shock sensor module 36 cancomprise a magnet mounted distally on a spring that is circumferentiallysurrounded by, and spaced from, a coil. One skilled in the art willappreciate, when the foot control assembly 30 is kicked or otherwisebumped by the operator, the magnet moves inside the coil and induces acurrent in the coil. Circuitry in the shock sensor module 36 of the footcontrol assembly 30 evaluates this voltage, and if it exceeds anadjustable voltage threshold, it will trigger a wake-up procedure forthe foot control assembly 30.

In operation, the foot control assembly 30 can be configured toautomatically switch to a sleep mode after a predetermined period ofinactivity to conserve battery life. The predetermined period ofinactivity, for example and without limitation, 10 minutes, 20 minutes,30 minutes, etc., can selectively be inputted by the operator into thesystem or can be preprogramed into the system. As described above, whenthe shock sensor module 36 detects a sharp vibration (light kick or tap)to the foot control assembly, the foot control assembly 30 reactivatesand returns to normal function.

In operation, the shock sensor module 36 is configured to allow for thefoot control assembly 30 to sit at various angles during storage and notcause false triggers, and it allows a sensitivity adjustment so slightvibrations won't trigger a false wake-up

In optional aspects, as shown in FIG. 21 , the foot control assembly 30can be configured to bind to a specific head unit microscope assembly sothat multiple head unit microscope assembly systems can operate in nearvicinity and not crosstalk. Further, the foot control assembly can beconfigured to be connected to the head unit microscope assembly by cablein case of radio interference, battery failure, or communicationsfailure.

Floor Stand Assembly

The floor stand assembly 40 can be used if the user does not have acurrent upgradable floor stand or wants added features that are providedby the floor stand assembly. The floor stand assembly 40 is configuredto be light weight, when compared to existing surgical operatingmicroscopes, which allows for easier movement of the floor stand and thecoupled head unit microscope assembly by the user. To stabilize thefloor stand assembly, the bottom portion of the floor stand isconfigured to accept the mounting of conventional weight plates, whichallows the selective addition of the required ballast to insure thedesired positional stability of the surgical microscope system. Invarious optional aspects, the floor stand assembly further can includecaster wheels for aiding in positioning the floor stand is the desiredposition and/or magnetic brakes to allow for locking of the floor standin the desired position. In a further aspect, the floor stand assemblycan include a bias element 43, such as, for example and withoutlimitation, a pneumatic spring, a coil spring, and the like, forassisting in the positioning of the arm member of the floor stand. Inthe exemplary aspect, and as shown in FIG. 1 and FIG. 2 , the distalportion 44 of the arm member 42 is configured to receive the mountingadaptor of the head unit microscope assembly.

Head Rest Assembly

The headrest assembly 60 is attachable to the head unit microscopeassembly and is configured to support the head, neck and back of a userwho leans against it, and the invention provides a selectable positionagainst which the user may lean in order to prevent neck and backstrain. An example of an exemplary headrest assembly 60 is disclosed inU.S. Pat. No. 9,772,497, the entire contents of which are herebyincorporated by reference.

Referring to FIG. 35 , the headrest assembly 60 is configured to beconventionally mountable to the binocular optics module 308 of themicroscope subassembly 300. In one aspect, the headrest assembly 60 caninclude preset values obtained from measurements of the user's face inorder to minimize practical difficulties in using adjustable settingsand also to reduce or eliminate strain to the neck and back of the user.In one aspect, the headrest assembly 60 can include two eyepieces 62that are connected to a mask 63 that defines a pair of eyepiece openings64. Optionally, the mask 63 can be formed to complement the facestructure of the user. As shown, each eyepiece 62 can include at leastone rigid sidewall and at least one optical element for transmittinglight beams from the optical device to the user's eye.

In the disclosed aspect, each eyepiece also has a first end 66 and asecond end 67. In this aspect, the first end of each eyepiece can beconfigured for attachment to a portion of the binocular optics module308 of the microscope subassembly 300 and the second end of eacheyepiece is mounted to the mask 65. As shown, each eyepiece alsoincludes a lens 68 that is positioned proximate the second end 67.Wherein a defined center of each lens 68 is spaced in relation to thecenter of the other said lens at a distance similar to a measuredpupillary distance (PD) of the user and is also positioned at a desiredeye relief distance, such that the user can rest their face against themask and thereby prevent neck and back strain.

References are made to block diagrams of systems, methods, apparatuses,and computer program products according to example embodiments. It willbe understood that at least some of the blocks of the block diagrams,and combinations of blocks in the block diagrams, may be implemented atleast partially by computer program instructions. These computer programinstructions may be loaded onto a general-purpose computer, specialpurpose computer, special purpose hardware-based computer, or otherprogrammable data processing apparatus to produce a machine, such thatthe instructions which execute on the computer or other programmabledata processing apparatus create means for implementing thefunctionality of at least some of the blocks of the block diagrams, orcombinations of blocks in the block diagrams discussed.

These computer program instructions may also be stored in anon-transitory computer-readable memory that can direct a computer orother programmable data processing apparatus to function in a particularmanner, such that the instructions stored in the computer-readablememory produce an article of manufacture including instruction meansthat implement the function specified in the block or blocks. Thecomputer program instructions may also be loaded onto a computer orother programmable data processing apparatus to cause a series ofoperational steps to be performed on the computer or other programmableapparatus to produce a computer implemented process such that theinstructions that execute on the computer or other programmableapparatus provide task, acts, actions, or operations for implementingthe functions specified in the block or blocks.

One or more components of the systems and one or more elements of themethods described herein may be implemented through an applicationprogram running on an operating system of a computer. They may also bepracticed with other computer system configurations, including hand-helddevices, multiprocessor systems, microprocessor-based or programmableconsumer electronics, mini-computers, mainframe computers, and the like.

Application programs that are components of the systems and methodsdescribed herein may include routines, programs, components, datastructures, etc. that may implement certain abstract data types andperform certain tasks or actions. In a distributed computingenvironment, the application program (in whole or in part) may belocated in local memory or in other storage. In addition, oralternatively, the application program (in whole or in part) may belocated in remote memory or in storage to allow for circumstances wheretasks can be performed by remote processing devices linked through acommunications network.

Although only a few exemplary embodiments have been described in detailherein, those skilled in the art will readily appreciate that manymodifications are possible in the exemplary embodiments withoutmaterially departing from the novel teachings and advantages of theembodiments of the present disclosure. Accordingly, all suchmodifications are intended to be included within the scope of theembodiments of the present disclosure as defined in the followingclaims.

We claim:
 1. A surgical microscope system, comprising: a processingsystem, wherein an at least one memory of the processing system isconfigured to store program instructions; an illumination systemcomprising: a plurality of light sources configured for illumination oftargeted tissue area of a patient, the plurality of light sourcescomprising a coaxial light source and a pair of oblique light sourcesthat are configured to illuminate the targeted tissue area at a selectedlight intensity level, wherein the coaxial light source forms a beam ofdivergent light that is configured to provide a wide dispersion of lightenergy on the targeted tissue area, wherein each of the plurality oflight sources comprises a large light emitting surface (LES) that has anillumination area of greater than about 20.0 mm², wherein the at leastone memory of the processing system is configured to store programinstructions that when executed cause the intensity of light energyincident on the targeted tissue area provided by the plurality of lightsources to be selectively configured such that the ratio of lightbetween the coaxial light source and the pair of oblique light sourcesare maintained at a user preference light ratio level setting, wherein acolor-rendering index of at least one of the plurality of light sourcesis at least 70, wherein each of the plurality of light sources isconfigured to generate a peak percentage level of normalized radiantpower having radiation with wavelengths between about 600 and 700 nm,and wherein each of the plurality of light sources is configured togenerate a color temperature of that is less than about 4500K.
 2. Thesurgical microscope system of claim 1, wherein the color-rendering indexof at least one of the plurality of light sources is at least
 90. 3. Thesurgical microscope system of claim 1, wherein the color-rendering indexof at least one of the plurality of light sources is between 95 and99.9.
 4. The surgical microscope system of claim 1, wherein thecolor-rendering index of each of the plurality of light sources is atleast
 70. 5. The surgical microscope system of claim 1, wherein thecolor-rendering index of each of the plurality of light sources is atleast
 90. 6. The surgical microscope system of claim 1, wherein thecolor-rendering index of each of the plurality of light sources isbetween 95 and 99.9.
 7. The surgical microscope system of claim 1,wherein each of the plurality of light sources are configured togenerate a peak percentage level of normalized radiant power havingradiation with wavelengths of about 650 nm.
 8. The surgical microscopesystem of claim 1, wherein each of the plurality of light sources isconfigured to generate a color temperature that is less than about3800K.
 9. The surgical microscope system of claim 1, wherein each of theplurality of light sources is configured to generate a color temperaturethat is between 3100K and 3900K.
 10. The surgical microscope system ofclaim 1, wherein each of the plurality of light sources is configured togenerate a color temperature that is between 3300K and 3600K.
 11. Thesurgical microscope system of claim 1, wherein the at least one memoryof the processing system is configured to store program instructionsthat when executed adjust the spectral makeup of the total lightgenerated by the coaxial light source and the pair of oblique lightsources to a desired spectrum of incident light in order to obtain alevel of desired red reflex from the light illumination incident on aneye of the patient.
 12. The surgical microscope system of claim 1,wherein the at least one memory of the processing system is configuredto store program instructions that when executed adjust the colortemperature of the total light generated by the coaxial light source andthe pair of oblique light sources to a desired color temperature levelof incident light in order to obtain a level of desired red reflex fromthe light illumination incident on an eye of the patient.
 13. Thesurgical microscope system of claim 1, wherein the beam of divergentlight emitted by the coaxial light source is centered between the user'sleft and right optical pathways.
 14. The surgical microscope system ofclaim 1, wherein the wide dispersion of light energy on a retina of apatient retina allows for more of an interior region of the eye to beilluminated while providing for evenly dispersed light energy across thetargeted tissue area.
 15. The surgical microscope system of claim 14,wherein light generated by the coaxial light source is configured tofill the targeted tissue area at a focal plane.
 16. The surgicalmicroscope system of claim 1, wherein the beam of divergent light isconfigured to be selectively decreased in diameter without increasingthe intensity of the light energy incident on the targeted tissue area.17. The surgical microscope system of claim 1, wherein the pair ofoblique light sources emit oblique beams that are angled at a desiredangle of incidence β between about 5 to 15 degrees, relative to anoptical axis.
 18. The surgical microscope system of claim 1, wherein thepair of oblique light sources are positioned on opposite sides of thecoaxial light source.
 19. The surgical microscope system of claim 1,wherein the illumination area of each large LES is greater than about30.0 mm².
 20. The surgical microscope system of claim 1, wherein theillumination area of each large LES is greater than about 35.0 mm². 21.The surgical microscope system of claim 1, wherein a total illuminationarea of the large light emitting surfaces of the coaxial light sourceand the pair of oblique light sources is between about 80 to about 140mm².
 22. A surgical microscope system, comprising: a processing system,wherein an at least one memory of the processing system is configured tostore program instructions; an illumination system comprising: aplurality of light sources configured for illumination of targetedtissue area of a patient, the plurality of light sources comprising acoaxial light source and a pair of oblique light sources that areconfigured to illuminate the targeted tissue area at a selected lightintensity level, wherein the coaxial light source forms a beam ofdivergent light that is configured to provide a wide dispersion of lightenergy on the targeted tissue area; wherein the at least one memory ofthe processing system is configured to store program instructions thatwhen executed adjust the spectral makeup of the total light generated bythe coaxial light source and the pair of oblique light sources to adesired spectrum of incident light in order to obtain a level of desiredred reflex from the light illumination incident on an eye of thepatient, wherein a color-rendering index of at least one of theplurality of light sources is at least 70, wherein each of the pluralityof light sources is configured to generate a peak percentage level ofnormalized radiant power having radiation with wavelengths between about600 and 700 nm, and wherein each of the plurality of light sources isconfigured to generate a color temperature of that is less than about4500K.
 23. The surgical microscope system of claim 22, wherein the atleast one memory of the processing system is configured to store programinstructions that when executed cause the intensity of light provided bythe plurality of light sources to be selectively configured such thatthe ratio of light between the coaxial light source and the pair ofoblique light sources are maintained at a user preference light ratiolevel setting.
 24. The surgical microscope system of claim 22, whereinthe at least one memory of the processing system is configured to storeprogram instructions that when executed adjust the color temperature ofthe total light generated by the coaxial light source and the pair ofoblique light sources to a desired color temperature level of incidentlight in order to obtain a level of desired red reflex from the lightillumination incident on an eye of the patient.
 25. A surgicalmicroscope system, comprising: a processing system, wherein an at leastone memory of the processing system is configured to store programinstructions; an illumination system comprising: a plurality of lightsources configured for illumination of targeted tissue area of apatient, the plurality of light sources comprising a coaxial lightsource and a pair of oblique light sources that are configured toilluminate the targeted tissue area at a selected light intensity level,wherein the coaxial light source forms a beam of divergent light that isconfigured to provide a wide dispersion of light energy on the targetedtissue area, wherein each of the plurality of light sources comprises alarge light emitting surface (LES) that has an illumination area ofgreater than about 30.0 mm², wherein the at least one memory of theprocessing system is configured to store program instructions that whenexecuted adjust the spectral makeup of the total light generated by thecoaxial light source and the pair of oblique light sources to a desiredspectrum of incident light in order to obtain a level of desired redreflex from the light illumination incident on an eye of the patient.26. The surgical microscope system of claim 25, wherein thecolor-rendering index of at least one of the plurality of light sourcesis at least
 70. 27. The surgical microscope system of claim 25, whereineach of the plurality of light sources is configured to generate a peakpercentage level of normalized radiant power having radiation withwavelengths between about 600 and 700 nm.
 28. The surgical microscopesystem of claim 25, wherein each of the plurality of light sources isconfigured to generate a color temperature of that is less than about4500K.
 29. The surgical microscope system of claim 25, wherein the atleast one memory of the processing system is configured to store programinstructions that when executed cause the intensity of light provided bythe plurality of light sources to be selectively configured such thatthe ratio of light between the coaxial light source and the pair ofoblique light sources are maintained at a user preference light ratiolevel setting.
 30. The surgical microscope system of claim 28, whereinthe at least one memory of the processing system is configured to storeprogram instructions that when executed adjust the color temperature ofthe total light generated by the coaxial light source and the pair ofoblique light sources to a desired color temperature level of incidentlight in order to obtain a level of desired red reflex from the lightillumination incident on an eye of the patient.
 31. A surgicalmicroscope system, comprising: a head unit microscope assemblycomprising: a processing system, wherein an at least one memory of theprocessing system is configured to store program instructions; anillumination system comprising: a plurality of light sources configuredfor illumination of targeted tissue area of a patient, the plurality oflight sources comprising a coaxial light source and a pair of obliquelight source that are configured to illuminate the targeted tissue areaat a selected light intensity level, wherein the coaxial light sourceforms a beam of divergent light that is configured to provide a widedispersion of light energy on the targeted tissue area, wherein each ofthe plurality of light sources comprises a large light emitting surface(LES) that has an illumination area of greater than about 30.0 mm², afoot control assembly in operative communication with the head unitmicroscope assembly; and a floor stand configured to support the headunit microscope assembly in a desired operative position, wherein the atleast one memory of the processing system is configured to store programinstructions that when executed adjust the spectral makeup of the totallight generated by the coaxial light source and the pair of obliquelight sources to a desired spectrum of incident light in order to obtaina level of desired red reflex from the light illumination incident on aneye of the patient.